Lateral Internal Sphincterotomy for Chronic Anal Fissure

  • Carol E. H. Scott-Conner
  • Jameson L. Chassin


Lateral internal sphincterotomy is indicated for a painful chronic anal fissure not responsive to medical therapy. This chapter describes the surgical technique.


Anal Canal Dentate Line External Sphincter Lower Border Internal Sphincter 
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Further Reading

  1. Abcarian H. Surgical correction of chronic anal fissure: results of lateral internal sphincterotomy vs fissurectomy—midline sphincterotomy. Dis Colon Rectum. 1980;23:31.PubMedCrossRefGoogle Scholar
  2. American Medical Association. Current procedural terminology: CPT ®. Professional ed. Chicago: American Medical Association; 2013.
  3. Lasheen AE, Morsy MM, Fiad AA. Segmental internal sphincterotomy – a new technique for treatment of chronic anal fissure. J Gastrointest Surg. 2011;15:2271.PubMedCrossRefGoogle Scholar
  4. Mazier WP. Hemorrhoids, fissures, and pruritus ani. Surg Clin North Am. 1994;74:1277.PubMedGoogle Scholar
  5. Nelson RL, Chattopadhyay A, Brooks W, Platt I, Paavana T, Earl S. Operative procedures for fissure in ano. Cochrane Database Syst Rev. 2011;11, CD002199.PubMedGoogle Scholar
  6. Notaras MJ. The treatment of anal fissure by lateral subcutaneous internal sphincterotomy: a technique and results. Br J Surg. 1971;58:96.PubMedCrossRefGoogle Scholar
  7. Sinha R, Kaiser AM. Efficacy of management algorithm for reducing need for sphincterotomy in chronic anal fissures. Colorectal Dis. 2011;10:1463.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Carol E. H. Scott-Conner
    • 1
  • Jameson L. Chassin
    • 2
  1. 1.Department of Surgery, Roy J. and Lucille A. Carver College of MedicineUniversity of IowaIowa CityUSA
  2. 2.Department of SurgeryNew York University School of MedicineNew YorkUSA

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